Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. SHANNON JACKIE CLARK
Active Sole ProprietorMRS. SHANNON JACKIE CLARK is a Contractor healthcare provider located in VAIL, Arizona. NPI 1700940855 is currently active in the NPPES registry. Verify at CMS.
Contractor · VAIL, AZ
Registration Details
- NPI Number
- 1700940855
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 21, 2006 (19.625969874201 yrs)
- Last Updated
- Dec 26, 2024
- License
-
11816 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12729 S OX CART TRLVAIL, AZ, 856419232Browse AZ providers · Browse ZIP 85641
- Phone
- 5122142841
- Fax
- 5207500056
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in VAIL, AZ
| Name | Credential | NPI |
|---|---|---|
| MARJORIE COLEMAN | — | 1336266485 |
| STEPHANIE WHITE | — | 1437277050 |
| MARLENE NATALINO STEVENS | — | 1558695882 |
| JACQUELINE MARIN | — | 1083938138 |
| MR. HECTOR ALBERTO JEFFREY | BHT | 1700281318 |
| CAROL VALLECALLE | — | 1407254394 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.